We use Google Analytics to see which pages are read and how the site is used, so we know what to improve. This only runs if you accept. See our privacy notice for details.

Dáil
‹ Leaders' Questions

Primary care centre selection controversy

Summary

Opposition deputies challenged the selection of additional primary care centres, especially Balbriggan, Dundalk and Swords, alleging fixed criteria, political interference and inadequate transparency linked to Deputy Shortall’s resignation. The Tánaiste denied ministerial involvement in individual site selection, defended the stimulus-funded expansion of primary care, supported Shortall’s reform efforts, and said documentation was publicly available, but did not commit to publishing all records immediately.

The ongoing saga of the selection of primary care centres, particularly in north County Dublin, continues unabated. The more the Minister for Health, Deputy Reilly, endeavours to explain himself, the more the number of questions that need to be answered. When one stands back to consider the situation, what emerges is the fact that a Labour Party Minister of State has resigned. The public outside Leinster House are baffled by the fact that a Minister of State who was pursuing the implementation of part of the programme for Government in an open and transparent way found it necessary to resign. People do not understand why. The general sense is that she was abandoned and isolated by the Tánaiste and her senior Labour Party colleagues.

From the outset and right up until yesterday, the answers about the site selection have kept changing. I understand that the Minister for Education and Skills, Deputy Quinn, was incensed that he took a fall because he had been given the wrong information, in that the former Minister, Ms Mary Harney, was wrongly blamed yesterday for the selection. Will the Tánaiste offer a definitive answer as to when the site was selected? To put an end to this issue, will he agree to publish all documentation and advices relating to it?

In a parliamentary reply on 16 May, the Minister for Health stated that the process represented a complete adherence to the system outlined by the then Minister of State, Deputy Shortall. There was no hint of a difference or addition. In June, the Fingal Independent reported that the Minister was signalling to people publicly that Balbriggan would be added. In July, he overrode the decision of his Minister of State. Will the Tánaiste agree to publish all of the relevant documentation and advices?

The Secretary General of the Department of Health, Mr. Ambrose McLoughlin, stated that he could not confirm whether he saw the final list. Something has become more noticeable in recent replies, particularly those last Thursday, in that the Minister has stated "I personally added", "the criteria were my criteria" or "they were decided by me". The Civil Service demarcation is clearly in evidence, in that the service was removed from what occurred subsequent to Deputy Shortall's list. This is an important issue. We could sort the situation out if all of the advices and documentation were published.

Was the Tánaiste consulted by the Minister on the added sites?

Comment on this

The Minister, Deputy Reilly, replied to these issues in the House yesterday. If Deputy Martin or another Deputy wishes to put questions to him, I am sure that he will happily reply. In any event, documentation is available publicly under the freedom of information system. I would have no difficulty with making documentation available.

I read newspaper reports this morning and met the Minister, his Department's Secretary General and the new CEO of the HSE. They told me that there had been no ministerial involvement of any kind in the selection of individual sites for primary care centres.

Regarding the issue of whether I was consulted, one must remember that this process occurred in the context of the production of an economic stimulus package worth €2.25 billion, which was announced by the Minister for Public Expenditure and Reform, Deputy Howlin.

A decision was taken to increase the number from 20 to 35. I was consulted about that and I agreed with the rationale for it. My primary concern was that we had a good stimulus package and it maximised the amount of input into the economy and the creation of jobs. I agreed with the increase from 20 to 35.

Comment on this

I find that an extraordinary response. Do not tell us we must depend on freedom of information; I am asking the Tánaiste, as deputy leader of the Government, to see to it that all the documentation will be published in the next couple of days. There is no reason it should not be. I do not want Secretaries General stating that correspondence with Ministers is confidential. On this issue, transparency demands that all the documentation be published now.

Comment on this

There should be no cover up.

Comment on this

We should not wait for two or three months for this storm to abate, with documentation then fed out with some of it redacted, as all previous experiences with freedom of information requests to the Government have shown.

Comment on this

No more cover ups from Labour.

Comment on this

There were no cover ups when Deputy McGrath supported the last Government.

Comment on this

I want the documentation published. Nobody stated that a Minister was involved in a selection of a site except the Minister for Education and Skills.

Comment on this

The Deputy was not there.

Comment on this

No more cover ups.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

Could we have a supplementary question?

Comment on this

We are talking about the adding on of centres. The mention of a stimulus package is a feeble response, as the former Minister of State, Deputy Shortall, was anxious that those most in need would get the allocation, and hence the list. Dundalk was 21st on the list and Swords was 144th on it. Does the Tánaiste stand over that? There could have been another 15 on Deputy Shortall's list beyond the 20 on the basis of an internationally recognised index of deprivation. That would have satisfied any stimulus needs but this was never a stimulus project. It is a project to develop primary care in accordance with the programme for Government. Internationally agreed criteria was drawn up between the HSE, the Department of Health and the former Minister of State, Deputy Shortall, who was at the time given responsibility for primary care. The Tánaiste abandoned her, consulted with the Minister for Health and agreed to divvy up the process for whatever reasons, be it political expediency or constituency reasons. The Tánaiste cannot admit it, be honest and say why there were additions to the list made in an arbitrary and unilateral way, completely at variance with the nine-month long job of work done by Deputy Shortall, her officials and the HSE. It is a very weak response to try to cover this up under the cloak of a stimulus package.

Comment on this

Perhaps the Deputy could teach the Tánaiste how to cover it up.

Comment on this

It is about transparency.

Comment on this

Of all the issues he can choose to raise here, with health Deputy Martin is in no position to-----

Comment on this
Deputies

Hear, hear.

Comment on this

Sorry, could the Tánaiste answer the question?

Comment on this

I answered the question.

Comment on this

People are fed up with this nonsense.

Comment on this

He should stop ducking and diving.

Comment on this

The Deputy is an architect of the HSE.

Comment on this
Bernard Durkan Deputy Bernard J. Durkan Fine Gael

Correct.

Comment on this

He was in the Government at a time when there was money in this country and he allowed the health system to deteriorate. He kept throwing money at it and ended up creating the HSE.

Comment on this

Answer the question.

Comment on this

We are doing-----

Comment on this

Are we to blame for the former Minister of State, Deputy Shortall, resigning on the Tánaiste's watch-----

Comment on this

We are reforming-----

Comment on this

-----and without his support? Am I to blame for that? Keep repeating the mantra.

Comment on this

-----the health system-----

Comment on this

The Government is reforming nothing.

Comment on this

-----at a time when there is less money-----

Comment on this

Dundalk was 21st and Swords was 144th in that list and the Tánaiste is standing over it.

Comment on this

Does the Deputy want the answer? He keeps bellyaching-----

Comment on this

I want the real answer.

Comment on this

-----about me not giving an answer-----

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

Could we have some order?

Comment on this

-----and every time I try to answer, he interrupts me. What the Deputy is doing-----

Comment on this

Which Secretary General and CEO of the HSE was involved?

Comment on this

He is the man who said there should be an end to politics as usual but he is continuing politics as usual.

Comment on this

We are reforming the health service at a time when less money is available and there are fewer staff. Our priority is to shift to primary care in our health system, and this is not just a matter of writing it down in a programme for Government or a document. We must provide-----

Comment on this

He is ignoring the question.

Comment on this

Will the Tánaiste provide the documentation?

Comment on this

Will the Deputy please listen to the answer? In order to deliver the reforms-----

Comment on this

Was it the previous Secretary General of the Department?

Comment on this

-----in the primary care system, we must provide the resources. That is what we were doing with the stimulus package and-----

Comment on this

Is it that the sites jumped the queue?

Comment on this

-----why the primary care centres were included in that stimulus package.

Comment on this
Bernard Durkan Deputy Bernard J. Durkan Fine Gael

Hear, hear.

Comment on this

The real story here is that whereas the Deputy opposite presided over the decline in our health service-----

Comment on this
Bernard Durkan Deputy Bernard J. Durkan Fine Gael

Correct.

Comment on this

The Tánaiste sacrificed his own Minister of State.

Comment on this

He sacrificed nothing.

Comment on this

-----this Government is making-----

Comment on this

Answer the question.

Comment on this

He sacrificed the Minister of State.

Comment on this

-----reforms and driving ahead-----

Comment on this

She was truly reforming.

Comment on this

-----with the provision of primary care systems. The Deputy says he never accused the Minister, Deputy Reilly, of this or that. I am cutting to the chase on this-----

Comment on this

You cut Deputy Shortall.

Comment on this

I asked the questions of the Secretary General of the Department of Health and the CEO of the HSE.

Comment on this

Will the Tánaiste publish the documentation?

Comment on this

I have told the Deputy the answer both gave me, which was that there was no ministerial involvement in the selection of individual sites.

Comment on this

I accepted that. I want to know about the documentation.

Comment on this

What was the story yesterday?

Comment on this

There is the Deputy's truth.

Comment on this

It was different.

Comment on this

Will the Tánaiste publish the documentation?

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

I call Deputy McDonald.

Comment on this

The Deputy opposite was there for a decade.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

I have called Deputy McDonald.

Comment on this

I welcome back the Tánaiste. He was missed as it was busy.

Comment on this

The Ceann Comhairle might deal with the little boy heckling.

Comment on this

Gerry was on it.

Comment on this

The Deputies can give it but cannot take it.

Comment on this
Deputies

Hear, hear.

Comment on this

A bit like the Labour Party.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

The Deputy should proceed.

Comment on this

There is still a picture of Deputy Finian McGrath in St. Luke's.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

The Deputy should proceed, without interruption.

Comment on this

Yesterday's statement by the Minister for Health, Deputy Reilly, regarding the primary care centre controversy has answered none of the key questions. What we know is that the Balbriggan site belonged to a Fine Gael supporter or advocate and was selected on the Minister's watch, and not that of the previous Government, as had been suggested.

The Minister for Health and the Taoiseach have consistently told the Dáil that there had been consultation with senior Labour Cabinet Ministers in respect of the change to criteria and the additional primary health care centres. The Minister for Social Protection, Deputy Burton, and the Minister for Public Expenditure and Reform, Deputy Howlin, all denied they were consulted. At least we now know where the senior level consultation happened, as the Minister, Deputy Reilly, spoke to the Tánaiste about the issue. So the Tánaiste has said.

When did the Tánaiste first become aware of concerns about the Minister's decision to locate two of the additional primary health care centres in his constituency? Did the former Minister of State, Deputy Shortall, bring her concerns to the Tánaiste before her resignation? Was he aware of those concerns when he signed off on the additional 15 health care centres? Was he aware of those concerns at the time he voted confidence in the Minister for Health, Deputy Reilly?

The Tánaiste made a speech about openness and reform, which he is manifestly failing to deliver. I cannot understand why despite unease within his political party - two MEPs have called for the Minister, Deputy Reilly, to do the decent thing and step down - the Tánaiste is still standing by him. I will quote the Minister's statement from yesterday, if I may.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

The Deputy is nearly a minute over her time.

Comment on this

How is this for clarity and transparency? He stated:

One and one makes two and two and two makes four but four by four makes 16 and not four and four which makes eight, and so it is with this. It is a logistical logarithmic progression.

Is he for real? It is clear as mud. The criteria were fixed, as the Tánaiste knows, and stroke politics was at the heart of the Government, as the Tánaiste knows.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

The Deputy should adhere to the directions of the Chair.

Comment on this

Answer my questions and we can see if the Tánaiste will stand by his promises for reform.

Comment on this

There is no secret about the fact that there were differences between the former Minister of State, Deputy Shortall, and the Minister for Health, Deputy Reilly. At all times I supported the former Minister of State, Deputy Shortall, in what she was seeking to do in the Department of Health.

Comment on this

She does not believe that.

Comment on this

There were a variety of meetings held, including one involving the Taoiseach, me, the Minister for Health and the former Minister of State, Deputy Shortall. That took place prior to the summer and we put in place a working group representative of the Taoiseach and my office to address some of these issues and make progress on them.

The working group has been making progress since then. My priority and that of the Government, bearing in mind that we are dealing with this at a time when we have a very serious financial difficulty, is to achieve reform in our health system. At the centre of that reform is a shift to primary care. There is a very good reason we want to shift to primary care; it is because people who want to access our health system have to go to their GP, somewhere else to get a blood test and somewhere else to get another-----

Comment on this

We know all of that. It is waffle. Answer the question.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

Allow the Tánaiste to continue without interruption.

Comment on this

It is not waffle to the parent of a sick child who has to go from Billy to Jack under our health system.

Comment on this
Deputies

Hear, hear.

Comment on this

Our priority as a Government is to get primary care centres provided, built, staffed and up and running.

Comment on this

The former Minister of State, Deputy Shortall does not think it is a priority.

Comment on this

Members of Sinn Féin were among those who constantly asked, day in and day out, where is the stimulus package and why is there not one. We have produced a stimulus package of €2.25 million and have taken the opportunity in that package to include the provision of primary care centres in order that we can provide in local communities a centre where somebody who is ill or who has a sick child can get the range of services provided under one roof rather than the ragged, disorganised, inefficient and costly system that we have at present. That is what the programme for Government states we will do and that is what we will press ahead to do.

On the question of whether I was involved in terms of the criteria, I was no more involved in the criteria for how primary care centres were selected in the Department of Health than I was involved in the criteria that were used in the Department of Education and Skills for the selection of schools or the criteria that were used in the Department of Transport for the selection of roads.

Comment on this
Deputies

Hear, hear.

Comment on this

What I was involved in, and am proud to have been involved in, was the production of a financial package, despite all the financial difficulties this country has, which provided for the building, staffing and resourcing of primary care centres and our pressing ahead with that. I recently nominated Deputy Alex White to be Minister of State to take charge of that and I am confident he will deliver on it as part of the team in the Department of Health.

Comment on this
Deputies

Hear, hear.

Comment on this

The Tánaiste is well aware that he does not have to convince anyone in this House as to the value and necessity of primary health centres, so I wish that he would dispense with what amounts to waffle when straight questions are put to him.

Comment on this

Let us piece it together now because the Tánaiste is not volunteering information - it has to be extracted from him.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

There is a time limit of one minute on this.

Comment on this

The Tánaiste signed off on the additional 15 primary health care centres. When he did that he was aware of Deputy Róisín Shortall's concerns. He told us that he did not know anything about the criteria. I suggest to him that as Tánaiste he should have paid more attention and, if he did not know about the criteria then I hope to God he will tell us that he has an understanding of the criteria now because none of the rest of us can make head nor tail of the incoherent bluster coming from the Minister, Deputy Reilly.

Comment on this
Seán Barrett An Ceann Comhairle Fine Gael

Thank you, Deputy.

Comment on this

There was a predetermined outcome to this and the criteria were fixed to achieve that. I think the Tánaiste knows that and that is the reason for his reluctance to spell out clearly and to answer clearly specific questions put to him. He signed off on the additional health centres; he did so knowing the difficulties and deep concerns Deputy Róisín Shortall had. He voted confidence in a Minister in whom I cannot see him having had any confidence. He hung Deputy Róisín Shortall out to dry and he makes no apology for doing that-----

Comment on this

That is rubbish.

Comment on this

-----and to top it all he will not even give a basic commitment, if he does not understand the criteria, to publish all of documentation for public scrutiny in order that the rest of us have the benefit of that information. Reform my eye.

Comment on this
Deputies

Hear, hear.

Comment on this

On the criteria, I did not see the Deputy make any complaint about the selection of the additional primary care centre in Deputy Adams' constituency. There was no complaint about that. I did not hear any complaint from the Deputy.

Comment on this

We have raised the 15 centres.

Comment on this

That is one of the 15.

Comment on this

Yes. We are raising the criteria that-----

Comment on this

I did not hear any complaint from Deputy McDonald about what criteria were used to decide on the selection of Grangegorman in the Deputy's constituency to develop a new third level education facility, which we are proud to do.

Comment on this

That was a previous Government's policy.

Comment on this

The key issue is that the Government is pressing ahead with the reform of the health service, with the provision of primary care centres which is what matters to the people and to those who want to see a better health care system. We are providing the funding for that and that was done in the stimulus package.

With regard to all the allegations, implications and so on that somehow there was political interference in it, as I said, I met today with the Minister, Deputy Reilly, the Secretary General of his Department, the new CEO of the HSE and they told me directly that there was no ministerial involvement in the selection of any individual site.

Comment on this

There was in terms of adding certain centres. The Tánaiste is being disingenuous.

Comment on this

I am not being disingenuous.

Comment on this